Organization
EVOLUTION MEDICAL SUPPLIES LLC
Active
Other names
Evo-med Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
COLIN MATIVO (MANAGER)
(714) 869-5650
Entity
Organization
Contact information
Practice address
6803 INTERNATIONAL AVE STE 201, CYPRESS, CA 90630-5114
(714) 869-5650
(562) 741-5889
Mailing address
6803 INTERNATIONAL AVE STE 201, CYPRESS, CA 90630-5114
(714) 869-5650
(562) 741-5889
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125409
HDMR LICENSE
CA
01
—
218049632-00001
SELLERS PERMIT
CA
Enumeration date
07/07/2022
Last updated
06/21/2025
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